lupus Flashcards
1
Q
what is systemic lupus erythematosus
A
an inflammatory autoimmune connective tissue disease
2
Q
leading causes of death in lupus
A
cardiovascular disease and infection
3
Q
pathophysiology of lupus
A
- characterised by ant-nuclear antibodies
- these are antibodies to proteins within the persons own cell nucleus
- immune system targets these proteins
- when immune system is activated by these antibodies targeting proteins in the cell nucleus it generates an inflammatory response
- inflammation in the full body
4
Q
symptoms of lupus
A
- Fatigue
- Weight loss
- Arthralgia (joint pain) and non-erosive arthritis
- Myalgia (muscle pain)
- Fever
- Photosensitive malar rash. This is a “butterfly” shaped rash worse with sunlight.
- Lymphadenopathy and splenomegaly
- Shortness of breath
- Pleuritic chest pain
- Mouth ulcers
- Hair loss
- Raynaud’s phenomenon
5
Q
investigations
A
- ANA
- anti-dsDNA
- anti-smith
- full blood count (normocytic anaemia)
- C3 and C4 levels decreased in active disease
- CRP and ESR raised in active inflammation
- immunoglobulins raised
- urinalysis for urine protein:creatine rato in lupus nephritis
- renal biopsy
6
Q
complications of lupus
A
- hypertension and coronary artery disease
- infection
- anaemia of chronic disease
- leucopenia, neutropenia, thrombocytopenia
- pericarditis
- pleuritis
- ILD - pulmonary fibrosis
- lupus nephritis
- optic neuritis, transverse myelitis or psychosis
- recurrent miscarriage
- venous thromboembolism
7
Q
first line treatment
A
- NSAIDS
- steroids (prenisolone)
- hydroxychloroquine (first line for mild)
- suncream and sun avoidance
8
Q
name some other commonly used immunosuppressants for resistant or more severe lupus
A
- methotrexate
- mycophenolate mofetil
- azathioprine
- tacrolimus
- leflunomide
- ciclosporin
9
Q
name some biological therapies for patients with severe disease or those who don’t respond to treatment
A
- rituximab
- belimumab
